Neutrophil-to-Lymphocyte Ratio (NLR) in Canine Inflammatory Bowel Disease (IBD)

Abstract

Inflammatory bowel disease (IBD) is a multifactorial chronic inflammatory disorder leading to structural changes in the intestinal wall. In humans, the neutrophil-to-lymphocyte ratio (NLR) has been proposed as a promising marker of IBD. This study evaluated the possible clinical and prognostic significance of the NLR in dogs with IBD. This retrospective study enrolled 41 dogs diagnosed with IBD presented to University of Pisa from January 2017 to January 2018. For each dog, age, sex, canine chronic enteropathy clinical activity index (CCECAI), endoscopic and histopathological grading were recorded. Complete blood count, serum total protein, albumin, cholesterol, and C-reactive protein at the time of endoscopy were recorded. A control group (CG) of healthy dogs from a blood donor database was built. NLR was calculated for both IBD and CG as the ratio between absolute neutrophils and lymphocytes. Presence of crypt distension, lacteal dilation (LD), mucosal fibrosis, intraepithelial lymphocytes was recorded. Follow-up information was obtained from electronic medical records and dogs were classified as responders and non-responders based on CCECAI variation between admission and the first recheck. IRE dogs showed higher NLR compared to healthy dogs. NLR correlated negatively with total protein, albumin, and cholesterol and correlated positively with CCECAI. Dogs with LD showed higher NLR than dogs without LD. Non-responders showed higher NLR compared to responders. In conclusion, as in IBD human patients, the NLR acts as an inflammatory marker providing further information on severity of the disease and could be useful in predicting treatment response.

Evaluation of Prognostic Factors, including Duodenal P-Glycoprotein Expression, in Canine Chronic Enteropathy

“…Several researchers have focused on studying the possibility of finding useful markers for predicting the response to treatment and the prognosis of dogs with CE. Until now, a high clinical activity index (canine inflammatory bowel disease activity index—CIBDAI, or canine chronic enteropathy clinical activity index—CCECAI) [ 5 , 6 ], hypocobalaminemia [ 7 ], hypoalbuminemia [ 2 ], high serum C-reactive protein concentration [ 5 ], high canine pancreatic lipase immunoreactivity concentration [ 8 ], and an elevated neutrophil-to-lymphocyte ratio [ 9 ] in IRE dogs have been identified as conditions correlated with a negative outcome with failure of treatment response. The role of P-glycoprotein (P-gp), concerning the failure in the response to treatment in CE, has been studied in recent years [ 10 , 11 ].…”

Neutrophil to lymphocyte ratio as a prognostic biomarker in puppies with acute diarrhea

“…12 In the aforementioned study, the NLR ≥6 had an 84.39% sensitivity and 86.95% specificity to identify dogs with SIRS; however, the study was unable to distinguish septic and nonseptic dogs. Benvenuti et al 27 have demonstrated that NLR values of dogs with inflammatory bowel disease to be statistically higher than those of healthy control dogs and a positive correlation (r = 0.528; P = 0.0004) between canine chronic enteropathy clinical activity index and NLR was identified. Similar to previous studies, the present study dogs with AD and SIRS+ had higher NLR values than healthy control dogs.…”

Gene expression of adipokines and inflammatory cytokines in peripheral blood mononuclear cells of obese dogs

“…The neutrophil‐lymphocyte ratio (N/L ratio) has been used as a marker of systemic inflammation and as an indicator of some inflammatory diseases in dogs (Benvenuti et al., 2020 ; Pierini et al., 2019 ). In this experiment, we were able to confirm if the N/L ratio increased in obese dogs.…”